Medically reviewed by Fedorchenko Olga Valeryevna, PharmD. Last updated on 2022-03-19
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Infectious and inflammatory diseases caused by amoxicillin-sensitive strains of microorganisms:
infections of the upper respiratory tract and ENT organs (acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis),
lower respiratory tract infections (acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia),
biliary tract infections (cholecystitis, cholangitis),
intestinal infections (salmonellosis),
infections of the genitourinary system and pelvic organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, salpingoophoritis, tuboovarial abscess, endometritis, bacterial vaginitis, postpartum sepsis, pelvioperitonitis, gonorrhea),
skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses, abscess, phlegmon, wound infection),
prevention of infectious and inflammatory diseases in surgery.
In / m (deep), in / in the form of injection or infusion.
The dosage regimen is set individually, depending on the severity of the course and localization of the infection, the sensitivity of the pathogen. Treatment should be continued for at least another 2-3 days after the disappearance of clinical symptoms of the disease, but not more than 14 days.
In the treatment of infections caused by beta-hemolytic streptococci, the drug is recommended to be used for at least 10 days.
Doses are given in terms of amoxicillin.
For adults and children over 12 years of age: the usual recommended dose is 1 g 2-3 times a day.
For the prevention of postoperative infections during operations lasting less than 1 hour during the introductory anesthesia, the drug is administered intravenously at a dose of 1 g. For longer operations, 1 g every 6 hours during the day. If there is a high risk of infection, the administration can be continued for several days.
For children: 6-12 years — 500 mg 3 times a day, 2-6 years-250 mg 3 times a day, up to 2 years-40-60 mg / kg 2-3 times a day. In severe infections, especially those caused by gram-negative pathogens, the daily dose of the drug (in terms of amoxicillin) it can be increased to 100 mg / kg / day.
Patients with impaired renal function. The dosage regimen is changed depending on the creatinine Cl: more than 30 ml/min — no change in the dosage regimen is required, 10-30 ml/min — treatment begins with an intravenous injection of 1 g, then 500 mg/2 times a day, less than 10 ml/min — 1 g, then 500 mg/day once.
Hemodialysis reduces the concentration in the blood plasma, and therefore during and at the end of dialysis, an additional 500 mg of the drug is administered intravenously.
In children with chronic renal failure, the usual single doses are used, increasing the intervals between injections, as indicated for adults.
Method of preparation of solutions
For intravenous administration: to the contents of the bottle (500 mg 250 mg or 1000 mg 500 mg) add 5 ml of water for injection.
Use freshly prepared solutions.
For intravenous administration: a single dose is dissolved in 0.9% sodium chloride solution or 5% dextrose (glucose) solution in a volume of 10 ml (for intravenous injection) to 100-200 ml (for intravenous infusion).
For intravenous infusion, dilution with a lactated Ringer solution is acceptable. When diluted with Ringer's lactated solution, the solution is prepared in 2 stages: first, sterile water is used for injection, then the resulting solution is diluted with Ringer's lactated solution.
With intravenous injection, the prepared solution is administered slowly.
With intravenous infusion, the prepared solution is administered slowly by drip for 15-60 minutes.
hypersensitivity to any of the components of the drug and other beta-lactam antibiotics,
infectious mononucleosis (including the appearance of a bark-like rash),
simultaneous administration of allopurinol (in the presence of skin allergic reactions when using penicillins),
a history of colitis associated with the use of penicillins.
With caution: severe hepatic insufficiency, gastrointestinal diseases, chronic renal failure, old age (due to possible renal failure).
Allergic reactions: urticaria, Quincke's edema, respiratory disorders, multiform exudative erythema, anaphylactic shock, exfoliative dermatitis, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis.
From the digestive system: nausea, vomiting, diarrhea, dyspepsia, epigastric pain, pseudomembranous colitis, increased activity of hepatic transaminases, cholestatic jaundice, hepatitis.
From the side of the hematopoietic organs: anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis.
From the central nervous system: hyperactivity, agitation, anxiety, insomnia, confusion, behavior change.
Other: candidamycosis, interstitial nephritis, development of superinfection.
Local reactions: burning and pain at the injection site, in some cases-phlebitis at the site of intravenous administration.
Symptoms: disorders of the gastrointestinal tract (nausea, vomiting, diarrhea) and water-electrolyte balance.
In case of overdose, it is recommended to stop the administration of the drug.
A small number of reports related to cases of interstitial nephritis with oliguric renal failure due to an overdose of amoxicillin. Such drug-induced kidney damage is reversible: kidney function is restored after discontinuation of the drug.
Treatment: symptomatic. Amoxicillin and sulbactam can be eliminated from the body by dialysis.
Amopidine® - a combined drug that has a bactericidal effect against amoxicillin-sensitive microorganisms, including beta-lactamase-producing strains.
Amoxicillin is a semisynthetic penicillin with a wide spectrum of activity from the group of aminopenicillins, which inhibits the synthesis of cell wall proteins of pathogenic microorganisms.
Sulbactam is an irreversible beta-lactamase inhibitor, expands the spectrum of amoxicillin activity against resistant strains whose resistance develops under the influence of beta-lactamases, does not change the activity of amoxicillin against sensitive strains, binds to some penicillin-binding proteins of bacteria, shows synergism when used simultaneously with beta-lactam antibiotics. It is stable in an aqueous solution, has independent antibacterial activity against Neisseria gonorrhoeae and Acinetobacter spp. and is resistant to most plasmid beta-lactamases.
Amoxicillin is active against the following microorganisms (including beta-lactamase-producing strains): aerobic gram-positive bacteria — Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus pyogenes, Streptococcus anthracis, Streptococcus pneumoniae, Streptococcus groups viridans, Enterococcus faecalis, Corynebacterium spp., Listeria monocytogenes, anaerobic gram-positive bacteria — Clostridium spp., Peptococcus spp., Peptostreptococcus spp., aerobic gram-negative bacteria — Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp., Salmonella spp., Shigella spp., Bordetella pertussis, Yersinia enterocolitica, Gardnerella vaginalis, Neisseria meningitidis, Neisseria gonorrhoeae, Moraxella catarrhalis, Haemophilus influenzae, Yersinia multocida, Campylobacter jejuni, Acinetobacter spp., Helicobacter pylori, anaerobic gram-negative bacteria — Bacteroides spp., including Bacteroides fragilis.
Binding to plasma proteins — 20%. Amoxicillin is distributed in most tissues and body fluids, penetrates the placental barrier, and is found in breast milk. T1/2 from the blood plasma-1 h. It is mainly excreted by the kidneys (glomerular filtration and tubular secretion) - 70-80% and with bile-5-10%.
Binding to plasma proteins-40%. T1/2 - 1 h. Sulbactam has no effect on the pharmacokinetics of amoxicillin. Sulbactam is almost completely excreted unchanged by the kidneys (75-85%). Sulbactam penetrates the placental barrier.
- Antibiotic-penicillin semi-synthetic beta-lactamase inhibitor [Penicillins in combinations]
The drug Amopidine® it is incompatible with aminoglycosides, blood derivatives, and protein lysis products, so they cannot be mixed in the same container.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect, bacteriostatic (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.
The use of probenecid may cause a decrease in renal tubular secretion, which leads to a prolonged increase in the concentration of amoxicillin in the blood plasma.
The drug Amopidine® it slows down the elimination of methotrexate, increases the effectiveness of indirect anticoagulants (blood clotting indicators need to be monitored), and reduces the effectiveness of oral contraceptives.
When combined with allopurinol, the risk of developing skin allergic reactions increases.